Trust Me I’m a Doctor show looks at Omega-3s

The Mother and Child Foundation’s Rachel Gow was one of the experts working behind the scenes in the BBC’s recent Trust Me I’m a Doctor show, looking at omega-3 and health.

Rachel is one of the country’s foremost authorities on ADHD, with a particular expertise in omega-3 fatty acids and the nutritional aspects of mental health.

The show posed the questions: “which is the best way to make sure you’re getting the omega-3 you need to keep you in tip-top health – oily fish or omega-3 supplements? And how much difference can taking either of these actually make to your health?”

“It was great to see the positive results of the show’s fish oil study with Liverpool John Moores University”, says Rachel. “Essentially they measured the omega-3 index of all participants and then randomised them to eating fish, taking fish oil supplements or a placebo. The omega-3 index is the sum of the omega-3’s EPA and DHA and can be measured via a finger prick test. It is a well-validated measure of the risk of cardiovascular disease, and sudden cardiac death. Low levels (i.e., less than 4%) are also linked to psychiatric illness.

“Those in both the oily fish and supplement groups raised their omega-3 index significantly out of the “at risk” category over the 8 week period placing them at lower risk of future health complications.”

High Risk to Low Risk

Illustration credit: bbc.co.uk

“In our limited timeframe the omega-3 fat levels in the blood cells of all the volunteers in those groups increased for the better”, says the BBC’s Trust Me I’m a Doctor webpage. “For some of them it moved them from the High Risk to the Low Risk category, which is very encouraging.

“All our volunteers had a fairly low omega-3 Index when the trial started – each group was around 4-5%, but some individuals were as low as 3%. So at the start of our trial, many volunteers were at a moderate to high risk of serious illness.

“After the trial, it’s a different story. The oily fish group and the omega-3 supplement group all leap to 7 – 8%, meaning they’re heading towards the low risk category.”

Fish or supplements?

The implications for better health prospects are clear.

“Were the people in the study to sustain this diet over a longer period of time, they might all move into the low risk category for serious illnesses like heart disease, stroke and diabetes”, says the BBC’s webpage for the show and study. “Even though we were giving people higher doses than you might normally take, the reality is, if you took lower doses over a longer timeframe – or incorporated omega 3 into your lifelong diet – then you’d likely see similar improvements.

“What’s more if you choose to get your omega 3 from oily fish, there are other benefits – fish is a great source of lean protein, and you’re also getting a range of vitamins and minerals.”

As to the question of “which is best, fish or supplements?”, the website notes: “Ultimately, the choice is yours, but one thing is clear – we could all do with more omega-3 in our diets if we want to cut our risk of serious illness.”

You can read more here, and those able to access it can watch the two TV programs on the BBC iPlayer until 15 March 2017.

2 Comments

This omega 3 “Trust me I’m a doctor” was an excellent programme. The most scary aspect was the fact that all had low omega 3 indices, meaning high risk of heart disease. There was just one problem: the use of white fish as a control to fish oil supplements and oily fish.

Fish oil, a triglyceride, is used for fat deposits and energy. The white meat of cod contains phosphoglycerides, used to form tissue – cell plasma membrane and internal structures – and influencing transport, signalling systems, nuclear receptors and much cell function. Moreover it contains nearly six times the amount of omega 3 DHA than corresponding fish oil.

The current enthusiasm for omega 3 rich oils is due to epidemiology not about fish oils but about fish and sea foods. The omega 3 index is a measure of whole blood. Had the blood cell membranes been analysed separately they would surely have been found enhanced by the white fish but not by the fish oil!

“The Tissue is the Issue”, as they say. Whereas the fish oil omega 3 would have arrived mostly in the plasma, the white fish omega 3 would have arrived mainly in the tissue, whose separate analysis would likely have reached significance, meaning that the white fish actually had a better tissue effect than the fish oil. Indeed there are studies showing better bio-availability of the phosphoglyceride form compared to triglyceride oils.

Misconceptions about this issue are rife – due to lack of nutritional science teaching – and lead to badly designed studies with conflicting results. My comment, however, does not in any way detract from the outcome of enhanced omega 3 index from the fish oil and oily fish. But casting white fish as an inconsequential source of omega 3 is far from the truth, and needs to be corrected.

Great to see a mainstream show covering this. One of the questions I always get asked is “does it matter if I don’t eat fish but take supplements?” Interesting and encouraging results here. Imagine if all importance science could be presented as accessibly as this! Thanks for covering it.